Article

Passive smoking as well as active smoking increases the risk of acute stroke.

Department of Medicine, Faculty of Medicine and Health Science, University of Auckland, New Zealand.
Tobacco Control (Impact Factor: 5.15). 06/1999; 8(2):156-60. DOI: 10.1136/tc.8.2.156
Source: PubMed

ABSTRACT To estimate the relative risk of stroke associated with exposure to environmental tobacco smoke (ETS, passive smoking) and to estimate the risk of stroke associated with current smoking (active smoking) using the traditional baseline group (never-smokers) and a baseline group that includes lifelong non-smokers and long-term (> 10 years) ex-smokers who have not been exposed to ETS.
Population-based case-control study in residents of Auckland, New Zealand.
Cases were obtained from the Auckland stroke study, a population-based register of acute stroke. Controls were obtained from a cross-sectional survery of major cardiovascular risk factors measured in the same population. A standard questionnaire was administered to patients and controls by trained nurse interviewers.
Information was available for 521 patients with first-ever acute stroke and 1851 community controls aged 35-74 years. After adjusting for potential confounders (age, sex, history of hypertension, heart disease, and diabetes) using logistic regression, exposure to ETS among non-smokers and long-term ex-smokers was associated with a significantly increased risk of stroke (odds ratio (OR) = 1.82; 95% confidence interval (95% CI) = 1.34 to 2.49). The risk was significant in men (OR = 2.10; 95% CI = 1.33 to 3.32) and women (OR = 1.66; 95% CI = 1.07 to 2.57). Active smokers had a fourfold risk of stroke compared with people who reported they had never smoked cigarettes (OR = 4.14; 95% CI = 3.04 to 5.63); the risk increased when active smokers were compared with people who had never smoked or had quit smoking more than 10 years earlier and who were not exposed to ETS (OR = 6.33; 95% CI = 4.50 to 8.91).
This study is one of the few to investigate the association between passive smoking and the risk of acute stroke. We found a significantly increased risk of stroke in men and in women. This study also confirms the higher risk of stroke in men and women who smoke cigarettes compared with non-smokers. The stroke risk increases further when those who have been exposed to ETS are excluded from the non-smoking reference group. These findings also suggest that studies investigating the adverse effects of smoking will underestimate the risk if exposure to ETS is not taken into account.

0 Followers
 · 
85 Views
  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic diseases are commonly studied through quantification and accumulation of risk factors. To reliably lead to an understanding of disease causation, however, the role of risk factors in the process of pathogenesis must be evaluated. This evaluation must consider in an in-tegrated way the full range of possible causes of chronic disease, which can be categorised as genetic, infectious and non-infectious environ-mental. To understand how to prevent disease causal risk factors need to be distinguished from risk factors that are spurious correlates of causal processes, and primary causes need to be distinguished from exacer-bating causes. Insights from evolutionary biology provide a foundation for this process by distinguishing feasible causal hypotheses from in-feasible ones. This paper applies this approach to the epsilon-4-associ-ated diseases as a paradigm for chronic diseases, and then considers atherosclerosis in more detailed as an illustration of epsilon-4-associ-ated diseases. The most parsimonious conclusion is that the epsilon-4-associated diseases in general and atherosclerosis in particular are for the most part infectious diseases that are exacerbated by the documented environmental and genetic risk factors.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Two hundred ischemic stroke patients and 193 age and sex matched healthy controls were studied for the presence of Angiotensin Converting Enzyme Insertion/Deletion (ACE I/D) gene polymorphism. The PCR studies revealed that ACE ‘II’ (OR = 2.055; p = 0.004) genotype and ‘I’ (OR = 1.411; p = 0.018) alleles were significantly associated with IS patients. Gender specific analysis revealed a strong association of ‘II’ (OR = 2.044; p = 0.014) genotype and ‘I’ (OR = 1.531; p = 0.011) allele withmale sex. Classification of patients based on TOAST criteria, revealed a significant association for ‘II’ genotype (OR= 1.713; p= 0.043) and ‘I’ (OR= 1.382; p= 0.039) allele in LVDpatients only. When the data was stratified based on age and sex, a statistically significant association was observed for ACE ‘II’ genotype (OR= 2.288; p= 0.006) and ‘I’ allele (OR= 1.395; p= 0.054) in ISmale patients of N50 years of age. The ACE ‘D’ allele was found to be increased in controls (OR= 0.709; p = 0.018) than IS patients. Multivariate logistic regression analysis showed that smoking and diabetes were the most powerful independent risk factor in LVD type of stroke. Thus,we presented here an evidence for a strong association of ACE ‘II’ genotype and ‘I’ allele compounded by factors such as smoking and diabetes among south Indian IS patients.
    09/2014; 2:661–669. DOI:10.1016/j.mgene.2014.09.003

Full-text (2 Sources)

Download
46 Downloads
Available from
Jun 1, 2014